| National Provider Identifier [NPI]: | 1447495411 |
| Last Name Of The Provider | RIOS |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1245 16TH ST |
| Street Address 2 Of The Provider | SUITE 125 |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904041235 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 959 |
| Number Of Medicare Beneficiaries | 302 |
| Total Submitted Charge Amount | 185407.23 |
| Total Medicare Allowed Amount | 62390.27 |
| Total Medicare Payment Amount | 44175.84 |
| Total Medicare Standardized Payment Amount | 40851.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1406.23 |
| Total Drug Medicare AllowedAmount | 448.77 |
| Total Drug Medicare PaymentAmount | 437.91 |
| Total Drug Medicare Standardized Payment Amount | 437.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 926 |
| Number Of Medicare Beneficiaries With Medical Services | 302 |
| Total Medical Submitted Charge Amount | 184001 |
| Total Medical Medicare Allowed Amount | 61941.5 |
| Total Medical Medicare Payment Amount | 43737.93 |
| Total Medical Medicare Standardized Payment Amount | 40413.93 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 171 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 173 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 66 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 171 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.1139 |